Department of Cardiovascular Medicine, St. Luke's International Hospital, Tokyo, Japan.
Tokyo Foundation for Policy Research, Tokyo, Japan.
PLoS One. 2024 Aug 23;19(8):e0305577. doi: 10.1371/journal.pone.0305577. eCollection 2024.
The left-digit bias (LDB), a numerical-related cognitive bias, not only potentially influences decision-making among the general public but also that of medical practitioners. Few studies have investigated its role in out-of-hospital cardiac arrest (OHCA).
We retrospectively included all consecutive patients with OHCA witnessed by family members registered in the All-Japan Utstein Registry of the Fire and Disaster Management Agency between January 1, 2005, and December 31, 2020. Target outcomes were the percentage of bystander cardiopulmonary resuscitation (BCPR) performed by family members or paramedics and the percentage of prehospital physician-staffed advanced cardiac life support (ACLS). Using a nonparametric regression discontinuity methodology, we examined whether a significant change occurred in the percentages of BCPR and ACLS at the age thresholds of 60, 70, 80, and 90 years, which would indicate the presence of LDB.
Of the 1,930,273 OHCA cases in the All-Japan Utstein Registry, 384,200 (19.9%) cases witnessed by family members were analyzed. The mean age was 75.8 years (±SD 13.7), with 38.0% (n = 146,137) female. We identified no discontinuities in the percentages of chest compressions, mouth-to-mouth ventilation, or automated external defibrillator (AED) usage by family members for the age thresholds of 60, 70, 80, and 90 years. Moreover, no discontinuities existed in the percentages of chest compressions, advanced airway management, and AED usage by paramedics or prehospital ACLS by physicians for any of the age thresholds.
In conclusion, our study did not find any evidence that age-related LDB affects medical decision-making in patients with OHCA.
左位数字偏差（LDB）是一种与数字相关的认知偏差，它不仅可能影响普通公众的决策，也可能影响医生的决策。很少有研究调查其在院外心脏骤停（OHCA）中的作用。
我们回顾性纳入了 2005 年 1 月 1 日至 2020 年 12 月 31 日期间由消防和灾害管理局全日本 Utstein 登记处登记的所有由家庭成员目击的 OHCA 连续患者。主要结局指标是家庭成员或护理人员实施的旁观者心肺复苏术（BCPR）的百分比和院前配备医师的高级心脏生命支持（ACLS）的百分比。使用非参数回归不连续方法，我们检查了在 60、70、80 和 90 岁年龄阈值处，BCPR 和 ACLS 的百分比是否发生显著变化，这表明存在 LDB。
在全日本 Utstein 登记处的 1930273 例 OHCA 病例中，分析了 384200 例（19.9%）由家庭成员目击的病例。平均年龄为 75.8 岁（±13.7 标准差），其中 38.0%（n=146137）为女性。我们未发现 60、70、80 和 90 岁年龄阈值处家庭成员进行胸外按压、口对口通气或自动体外除颤器（AED）使用的百分比存在不连续。此外，在任何年龄阈值处，护理人员进行胸外按压、高级气道管理和 AED 使用或医师进行院前 ACLS 的百分比也不存在不连续。
总之，我们的研究没有发现任何证据表明年龄相关的 LDB 会影响 OHCA 患者的医疗决策。
